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Professional FAQs: What Is The Prognosis For Systemic Lupus?

© Provided by Getty Images MD · 40 years of experience · USA

Systemic lupus is an autoimmune disease. Which affects the brain, skin, kidneys, lungs, and even brain. Autoimmune disease is a specific disorder where the body kills its cell, by identifying them as foreign particles. It can also be explained that in autoimmune diseases the white blood corpuscles are unable to differentiate between the body cells and the foreign particles, hence a person's body kills his cells.

→ See more questions and expert answers related to systemic lupus erythematosus.

→ Learn more about systemic lupus erythematosus: See the causes, symptoms, treatment options and more.

MBBS · 2 years of experience · India

No cure is available for lupus erythematosus/hp-systemic lupus erythematosus?Ocid=feed-health-article" target="_blank">systemic lupus erythematosus (SLE) but there are many treatments for the disease. In the 1950s, most people diagnosed with SLE lived less than five years. Today, over 90% now survive for more than ten years, and many live relatively symptom-free. 80-90% can expect to live a normal lifespan. Mortality rates are, however, elevated compared to people without SLE. The prognosis is typically worse for men and children than for women; however, if symptoms are present after age 60, the disease tends to run a more benign course. Early mortality, within 5 years, is due to organ failure or overwhelming infections, both of which can be altered by early diagnosis and treatment.

→ See more questions and expert answers related to systemic lupus erythematosus.

→ Learn more about systemic lupus erythematosus: See the causes, symptoms, treatment options and more.

MBBS · Less than a year of experience · India

Systemic lupus erythematosus (SLE) is still a disease with significant mortality. Although 5 yr after diagnosis 92% of patients are alive. The prognosis falls to 82% survival at 10 year. 76% at 15 year and only 68% at 20 year in Toronto.

→ See more questions and expert answers related to systemic lupus erythematosus.

→ Learn more about systemic lupus erythematosus: See the causes, symptoms, treatment options and more.


What Is Lupus? Symptoms, Causes And Treatments

Many scientists believe lupus develops in response to various factors, including hormones, environment and genetics.

Hormones

Women are far more likely than men to develop lupus, and experts think the hormone estrogen may impact the severity of symptoms.

Research shows women with lupus tend to have more severe flares when estrogen levels are high, such as right before their periods and during pregnancy. Additional evidence suggests women who are taking exogenous estrogen—estrogen that comes from outside of the body, such as the kind found in birth control pills or hormone replacement therapy—have a higher risk of developing lupus, according to Dr. Choi. "Experts believe that sex hormones play an important role in the immune system, and patients can develop lupus when these sex hormones cause abnormal expression of genes involved in the regulation of immune cells," she adds.

Environment

Many environmental factors, such as air pollution, exposure to heavy metals, and even certain infections, including the Epstein-Barr virus, may increase SLE risk, but more research is needed. However, exposure to cigarette smoke as well as to the mineral silica (construction workers and those who dig or drill in the earth can have high exposures) are strongly associated with the development of lupus .

Another environmental factor that influences lupus, but doesn't cause it, is ultraviolet light, either from the sun or indoor fluorescent lighting. Ultraviolet light causes cell damage in all of us, but in people with lupus, the immune system takes longer to clear that cell damage and can also mistakenly launch an attack against healthy cells, causing a lupus flare up. In fact, one study published in the Journal of the American Academy of Dermatology reports 81% of participants with lupus as being sensitive to light .

Diet may also be an environmental factor, with some recent studies linking an increase in diseases, such as lupus, to the rise and spread of the Western diet rich in processed foods, meats, dairy and oils. Eating an anti-inflammatory diet, managing stress and moods, and getting quality sleep may all help manage lupus symptoms.

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Take Quiz Genetics

Scientists have identified roughly 100 gene variations that can lead to lupus. However, having one of  these variations doesn't automatically mean you'll get the disease. Researchers believe a "trigger," such as exposure to a medication, stress or hormones, sets the disease in motion. In rare instances, infants can be born with neonatal lupus. Not all mothers of infants with neonatal lupus have lupus themselves, though they have about a 20% risk of developing lupus later in life .


New Insights Into Systemic Lupus Erythematosus-associated Pulmonary Arterial Hypertension

A team from Peking Union Medical College Hospital in Beijing, China, have explored changes in the characteristics, treatment, and 5-year survival for SLE-associated PAH in the last decade, and possible reasons for survival change. To date, this is the largest multi-center prospective SLE-PAH cohort to describe disease characteristics and prognosis. The results have been shared at the 2023 annual congress of EULAR—the European Alliance of Associations for Rheumatology.

A multi-center prospective cohort of 610 patients with SLE-associated PAH was established, and divided into cohort A and B according to the date that people underwent a right heart catheterization procedure. Cohort A was 2011 to 2016, and cohort B was 2016 to 2021. In tandem, a single-center cohort of 104 idiopathic pulmonary arterial hypertension (IPAH) was recruited as a control group in order to describe baseline characteristics and survival. Disease characteristics, treatment regimen, and all-cause mortality were compared between cohorts A and B.

In their abstract, Dong and colleagues report that SLE PAH patients were overall younger, predominantly female, and had lower levels of NTproBNP—an important cardiac biomarker. They also had better functional status, better hemodynamics, and higher 5-year survival than IPAH patients.

Compared with cohort A, those in cohort B showed lower mean pulmonary arterial pressure and pulmonary vascular resistance. They were also more likely to receive intensive immunosuppressants and PAH targeted medication. The 5-year survival rate was higher in cohort B: 88.1% versus 72.9% in cohort A. Analysis showed that treatment goal achievement of PAH and reaching lupus low disease activity state (LLDAS) were both independently associated with lower mortality.

This study shows that survival has improved significantly for SLE-associated PAH. The findings demonstrate that early detection of PAH in SLE patients and achieving treatment goals for both PAH and SLE contribute to improved survival.

More information: Conference: congress.Eular.Org/

Provided by European Alliance of Associations for Rheumatology (EULAR)

Citation: New insights into systemic lupus erythematosus-associated pulmonary arterial hypertension (2023, June 2) retrieved 23 June 2023 from https://medicalxpress.Com/news/2023-06-insights-lupus-erythematosus-associated-pulmonary-arterial.Html

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